In November 2015, CMS Medicare and Medicaid billing and reimbursement requirements for Orthopedic procedures changed dramatically, shifting many Orthopedic practices from a fee-for-service to a new bundled payment model for hip and knee replacement surgery in acute-care hospitals, as well as many other Orthopedic procedures. The CJR model’s goal is to give hospitals a financial incentive to work with physicians, home health agencies, skilled nursing facilities and other providers, promoting coordinated care.

While these new regulations may seem extremely overwhelming for many Orthopedic practices, with a careful planning and practice analysis, it is entirely possible to manage a very successful medical practice under the new bundled payments model.

Orthopedic Practice Analysis

Global Health Management Services provides a complimentary benchmark analysis that demonstrates the performance of your Orthopedic revenue in accordance with national and regional measures. Our courtesy evaluation provides a comprehensive assessment of each element of your Orthopedic revenue cycle which includes the accuracy of your coding, billing and reimbursement practices.

Global Health offers a wide variety of Orthopedic Medical Billing and Practice Management services. To better customize the menu of benefits for your practice, our Orthopedic Medical Practice Management Consultants conduct a complimentary comparison to demonstrate how your business compares with similar providers, practices and medical facilities. The analysis results provide the specifics for coordinating the most efficient and comprehensive strategy for increasing your revenue.

Clients are welcome to choose one or any combination of our Orthopedic Practice Management services. Our informed recommendation, and the preference of the majority of our Orthopedic clients, supports the bundling of our Orthopedic practice management services to streamline the revenue cycle while reducing expenses.

Orthopedic Practice Management services:

AR Management

Claims Appeal Services

Orthopedic Practice Analytics

Medical Billing

Orthopedic Coding by Certified Medical Coders

Medical Collections Services

Orthopedic Provider Credentialing

Payer Contracting Services

Payer Contract Negotiations

Orthopedic Contract Negotiation

Payer contract negotiations, evaluation and renegotiations is very critical to every Orthopedic practice, yet many practices only set up their managed contracts one time and allow them to automatically renew without any negotiations. Most Orthopedic practitioners lose additional revenue of 10-30 percent because they do not have the time or the required expertise to renegotiate contracts with insurance payers.

Now more than ever, it has become crucial to have a professional medical billing companyspecializing in Orthopedic medical billing and coding that can navigate through the complexities of the Orthopedic coding requirements.

GHMS’s Orthopedic Medical Billing specialists can manage all aspects of your Orthopedic practice’s billing and revenue cycle and will work in conjunction with your Orthopedic practice to ensure you receive the appropriate reimbursement for services performed. We focus on maximizing every bill to each payer by also ensuring compliancy and sending each bill out in a prompt and timely manner resulting in the fastest revenue response from the payer directly to your Orthopedic practice.

Our Orthopedic Billing Specialists will

analyze, recognize and advise you of the advantages of reimbursement fee trending

keep current with insurance specifications and regulations and ensure the fees are kept at the maximum allowable reimbursement

focus on accurate procedure and diagnosis codes so claims are not suspended or rejected

carefully analyze insurance payments and Explanation of Benefits to ensure accurate payment and take appropriate action if necessary

Our team of Orthopedic billing specialists will work closely with your practice and provide the necessary and continuing education on the best documentation and billing practices for procedures performed, including keeping your Orthopedics practice up to date with the latest CMS Medicare, Medicaid billing and documentation requirements, certifications and regulations.

At Global Health Management Services we make sure that you receive the maximum amount covered by the insurance companies while minimizing out of pocket expenses for your patients.

In order to maximize your revenue, it’s important to have Orthopedic billers and coders who specialize in Orthopedic practices and who understand the requirements needed to successfully bill Medicare, Medicaid and insurance companies for payment in order to receive the maximum allowable reimbursements. At GHMS, we are Orthopedic Billing and Coding experts with proven results for our Orthopedic clients.

Orthopedic AR Management

Global Health Managements Services’ innovative Orthopedic A/R Management coupled with our collection services have been providing Orthopedic practices improved collections over the past two decades. We are able to improve collections within a short period of time.

Our success comes from accurate, timely and professional Orthopedic billing followed by serious A/R follow up and collection activity by dedicated professionals who use technology to process and accomplish the task of collecting more, faster.

Each claim is meticulously tracked and followed up by our trained and experienced medical billing staff until the payment is received.

We have dedicated Orthopedic A/R managers to follow up with payers and patients.

Internal processes are clearly laid out to expedite collections and ensure follow through for each claim.

“Our orthopedic practice, which is one of the largest practices in the state of New Jersey, hired Global at a critical time with very little advanced notice. They did a terrific job at turning around our billing operation by maximizing collections.